Incidental Cholecystectomy During Colorectal Surgery

Asymptomatic Gallstones (AsGS) – To Treat or Not to?

“…It has been observed that cholecystectomy is required in up to 40% of these patients within one year of the initial operation. A prophylactic cholecystectomy at the time of the initial operation is usually advised [30][31][32][33]. However, it should be performed only if cholecystectomy does not add to the risk, patient has been informed and consent taken for the additional procedure; it requires planning for incision and is contraindicated when a prosthetic material is being used.…”

The Cholegas Study: safety of prophylactic cholecystectomy during gastrectomy for cancer: preliminary results of a multicentric randomized clinical trial

“…Due to such higher rate of gallstones, some Authors proposed prophylactic cholecystectomy, advocating that concomitant cholecystectomy is not time consuming and substantially with minimal additional risks for the patients [14][15][16], while subsequent cholecystectomy (in most cases attempted laparoscopically) is known to be more challenging after gastric surgery, with an increased risk of conversion, bile duct injuries and a longer operating time [17,18]. Another advantage of prophylactic cholecystectomy was represented by the avoidance of a possible reintervention in case of acute post-operative cholecystitis [7,19,20] and the avoidance of difficult procedures like endoscopic retrograde cholangiography (ERC) in the presence of Roux-en-Y reconstruction.…”

Incidental Cholecystectomy in Patients with Asymptomatic Gallstones Undergoing Surgery for Colorectal Cancer

“…However, the feasibility of incidental cholecystectomy during colorectal cancer surgery had not been determined [4]. Juhasz et al [11] reported that prophylactic cholecystectomy was found to be associated with a low risk of additional biliary complications, whereas the rate of long-term biliary complications was much higher in patients who did not undergo cholecystectomy. These findings suggested that patients with asymptomatic cholelithiasis who undergo colorectal surgery should undergo concomitant cholecystectomy, in the absence of clear contraindications.…”

“…Silent gallstones are often detected incidentally during preoperative imaging for abdominal surgery, with an incidence ranging from 20 to 30% [8,9]. Several previous studies suggested that incidental cholecystectomy during abdominal surgery for unrelated conditions be justified, due to the high risk of cholecystitis or biliary complications following laparotomy, as long as there are no contraindications [10,11,12,13,14]. Surprisingly, few studies have reported on incidental cholecystectomy during colorectal surgery, but their results have been inconsistent [11,14].…”

“…Several previous studies suggested that incidental cholecystectomy during abdominal surgery for unrelated conditions be justified, due to the high risk of cholecystitis or biliary complications following laparotomy, as long as there are no contraindications [10,11,12,13,14]. Surprisingly, few studies have reported on incidental cholecystectomy during colorectal surgery, but their results have been inconsistent [11,14]. The increasing incidence of colorectal cancer (CRC) has been accompanied by an increased rate of CRC patients with asymptomatic cholelithiasis, thus making it important to verify the feasibility of incidental cholecystectomy during colorectal surgery.…”